An effective Quality Improvement Program requires:

  • skilled data aggregation and analysis,
  • realistic timed achievement goals,
  • focused on the provider site’s patient population needs,
  • involves thoughtful and intricate planning,
  • persistent and intentional implementation, and
  • reassessment to determined QI success.

CMS Solutions provides comprehensive guidance throughout the QI process including data analytics, project planning and implementation, transformative training, tools and resources.

The Institute of Medicine defines health care quality as “the degree to which health care services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.”

measuring quality

Determined by some measurement, health care quality is a level of value provided by any health care resource. These measures are usually defined by governing agencies, and accrediting organizations based on historical data and goals for establishing a minimum standard of care. Measures used to rate the level of quality care and service delivered by a provider or healthcare resource are based on the general population served by the provider, and sub-populations further classified by particular attributes such as a demographic identifier, health problem, and  health insurance plan.

Set Your Mark… Let’s Go!

CMS Solutions offers a number of services designed to help

healthcare companies set their mark in healthcare.

CMS Quality Services

All Eligible Clinicians should particiapte in Quality Payment Programs (QPP). Report Merit -based Incentive Payment System (MIPS)  measures or Advanced Alternative Payment Model (AAMP) and participate in improvement activities that optimize clinical practice.

How We Help:

  • Strategic approaches to sustainable success under appropriate care models
  • Guidance in meeting requirements under developing payment models through correct use of revenue codes
  • Support for measure selection aligning to your goals and priorities across MIPS categories
  • Reporting support through our Healthcare Data & Analytics services

CMS offers a number of consulting solutions  to help your organization’s before, during and after completion of the transformation process from basic guidance of project self-management to the comprehensive project facilitation.

Accountable Care Organizations provide coordinated care and chronic disease management while lowering costs.

Medicare offers several ACO programs, including:

  • Medicare Shared Savings Program – For fee-for-service beneficiaries
  • ACO Investment Model – For Medicare Shared Savings Program ACOs to test pre-paid savings in rural and underserved areas
  • Advance Payment ACO Model – For certain eligible providers already in or interested in the Medicare Shared Savings Program
  • Comprehensive ESRD Care Initiative – For beneficiaries receiving dialysis services
  • Next Generation ACO Model – For ACOs experienced in managing care for populations of patients
  • Pioneer ACO Model – Health care organizations and providers already experienced in coordinating care for patients across care settings

“When an ACO succeeds in both delivering high-quality care and spending health care dollars more wisely, it will share in the savings it achieves for the Medicare program.”

Clinical Quality Measures (CQMs) are the vehicle by which organizations validate the level of quality delivered to their patients.

MR Reviews are conducted by CMS Solutions’ team of experienced reviewers, which include Certified Content Experts and skilled healthcare professionals. The analysis compares the organizations care delivery and patient experience against select measures. A comprehensive report of our findings is provided upon completion.

CMS Solutions Healthcare Quality Management is designed to ensure healthcare providers are delivering care that is:

  • Effective,
  • Safe,
  • Efficient,
  • Patient-centered,
  • Equitable, and
  • Timely.